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| __NOTOC__ | | __NOTOC__ |
| {{Urethritis}} | | {{Urethritis}} |
| | {{CMG}}{{AE}}{{MehdiP}} |
| | ==Overview== |
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| Clinicians should attempt to obtain objective evidence of urethral inflammation. However, if clinic-based diagnostic tools (e.g., Gram-stain microscopy) are not available, patients should be treated with drug regimens effective against both [[gonorrhea]] and [[chlamydia]].
| | ==Laboratory Findings== |
| | | urethritis is considered on the basis of any of the following: |
| Urethritis can be documented on the basis of any of the following signs or laboratory tests:
| | :1-Mucoid, mucopurulent, or purulent discharge on examination. |
| | | :2-Gram stain of urethral secretions demonstrating ≥2 [[WBC]] per field |
| *'''Mucopurulent or purulent discharge on examination'''.
| | :3-Positive leukocyte esterase test on first-void urine or microscopic examination of sediment from a spun first-void urine demonstrating ≥10 [[WBC]] per high power field. |
| *'''Gram stain of urethral secretions demonstrating ≥5 WBC''' per oil immersion field. The Gram stain is the preferred rapid diagnostic test for evaluating urethritis and is highly sensitive and specific for documenting both urethritis and the presence or absence of gonococcal infection. Gonococcal infection is established by documenting the presence of WBC containing GNID.
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| *'''Positive leukocyte esterase test''' on first-void urine or microscopic examination of first-void urine sediment demonstrating ≥10 WBC per high-power field.
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| If none of these criteria are present, testing for[[ N. gonorrhoeae]] and [[C. trachomatis]] using NAATs might identify additional infections (248). If the results demonstrate infection with either of these pathogens, the appropriate treatment should be given and sex partners referred for evaluation and treatment. If none of these criteria are present, empiric treatment of symptomatic males is recommended only for men at high risk for infection who are unlikely to return for a follow-up evaluation. Such patients should be treated with drug regimens effective against gonorrhea and chlamydia. Partners of patients treated empirically should be evaluated and treated, if indicated.
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| ===Nongonococcal Urethritis Diagnosis===
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| All patients who have confirmed or suspected urethritis should be tested for gonorrhea and chlamydia. Testing for [[chlamydia]] is strongly recommended because of the increased utility and availability of highly sensitive and specific testing methods (e.g., NAATs) and because a specific diagnosis might enhance partner notification and improve compliance with treatment, especially in the exposed partner.
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| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Laboratory Findings
urethritis is considered on the basis of any of the following:
- 1-Mucoid, mucopurulent, or purulent discharge on examination.
- 2-Gram stain of urethral secretions demonstrating ≥2 WBC per field
- 3-Positive leukocyte esterase test on first-void urine or microscopic examination of sediment from a spun first-void urine demonstrating ≥10 WBC per high power field.
References
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